Training and instruction device for performing cricothyroidotomy

ABSTRACT

A training and instruction device for performing a cricothyroidotomy on a patient having an upper airway obstruction and including an anatomical model of the human throat formed with a cricothyroid notch for visual and tactile instruction of the location of the cricothyroid notch and the corresponding anatomical landmark on the patient, and a hollow bore needle demountably secured adjacent the model for removal and insertion into the throat of the patient at the thus identified cricothyroid notch.

United States Patent Cioppa [451 Dec. 5, 1972 [s41 TRAINING ANDINSTRUCTION 2,689,415 9/1954 Haver ..3s/17 DEVICE FOR PERFORMING2,159,925 5/1939 Wood... CRICOTHYROIDOTOMY 2,966,986 1/1961 Jones..206/63.2

[72] Inventor: Forrest J. Cioppa, 3346 Vaughn Primary Examiner-Wm. H.Grieb Road Lafayette Cahf 94549 Attorney-Warren, Rubin, Brucker 8LChickering [22] Filed: July 13, 1970 211 App]. No.: 54,283 [57] ABSTRACTA training and instruction device for performing a cricothyroidotomy ona patient having an upper airi fi gg Way obstruction and including ananatomical model of 58] Fieid 5/17 49 206/63 2 R the human throat formedwith a cricothyroid notch for 5 6 5 visual and tactile instruction ofthe location of the cricothyroid notch and the corresponding anatomicallandmark on the patient, and a hollow bore needle [56] References citeddemountably secured adjacent the model for removal UNITED STATES PATENTSand insertion into the throat of the patient at the thus 3 I82 6635/1965 Abelson 128/305 identified cricothyroid notch. 3,376,659 4/1968 4Claims, 4 Drawing Figures Asin et al. ..35/l7 INSTRUCTIONS 2 1.nvnzasxrsuo sent.

z. PALPATE CRICOTNVROID Norm on MODEL AND on PATIENT- a-snzmuz; SKIN.4-PIERCE TRAcHEA WITH NEEDLE BEING CAREFUL TO REGULATE DEPTH OFPENETRATION.

TRAINING AND INSTRUCTION DEVICE FOR. PERFORMING CRICOTIIYRO-IDOTOMY Theinvention relates to medical instruments and more particularly tosurgical training and instructional devices.

Whatever its cause, obstruction of the upper airway in a human beinggives rise to an emergency whichmay easily prove fatal. In suchcircumstances a trained surgeon might immediately perform acricothyroidotomy by entering an auxiliary airway at the cricothyroidmembrane. This is a comparatively simple procedure when performed by askilled and knowledgeable surgeon and involves minimum risk or danger tothe patient. The latter is true where entry is made at the properlocation of the throat and which is conveniently marked at thecricothyroid notch. A serious problem, however, arises when theemergency occurs in the absence of a skilled surgeon and whenphysicians, nurses, ambulance attentants and other paramedical personnelmust act quicklyif the life of the patient is to be saved. In such casethe finding of the precise point at which the airway is to be insertedis the problem. To insert the airway above or below the desired spot mayresult in serious complications. For this reason the suggested procedurehas not been more widely adopted and used with the result that manylives are lost each year.

An object of the present invention is to providea training andinstruction device for performing a cricothyroidotomy which will assistphysicians who are non-surgeons, dentists, nurses and medical aidpersonnel who may otherwise be unsure of detailed neck anatomy, to movesurely and precisely to the exact point of safe entry into the patientsthroat, viz. the cricothyroid notch and to insert a hollow bore needleinto the interior airway of the throat all within the very short periodof time available in the emergency, lifethreatening situation describedwhere death may be but a moment away.

Another object of the present invention is to provide a relatively smallwall mounted device which may be conveniently mounted in doctorsoffices, emergency rooms, ambulances and the like, and which willprovide most effective combined visual and tactile instruction in theperforming of a cricothyroidotomy.

The invention possesses other objects and features of advantage, some ofwhich with the foregoing will be set forth in the following descriptionof the preferred form of the invention which is illustrated in thedrawing accompanying and forming part of this specification. It is alsoto be understood, however, that variations in the showing made by thesaid drawing and description may be adopted within the scope of theinvention.

Referring to said drawing:

FIG. 1 is a front elevation of a training and instruction device forperforming a cricothyroidotomy;

FIG. 2 is a plan view of the device;

FIG. 3 is a side elevation of the device;

FIG. 4 is a side elevation of a hollow bore needle forming part of thepresent device.

The training and instruction device of the present invention consistsbriefly of a three-dimensional anatomical model 6 of the human throatformed with a cricothyroid notch 7 for visual and tactile instruction ofthe location of this notch and the corresponding anatomical landmark onthe patient, and a hollow bore needle 10 demountably secured adjacentthe model 6 for removal and insertion into the patients throat at thecricothyroid notch thus identified. Preferably the model is formed of asoft resiliently compressible material such as natural or syntheticrubber and of a size and shape closely resembling that of the humanlarynx with the cricothyroid notch 7 in clear relief and easilyidentifiable to palpation; The model may be composed of plastic tosimulate the cartilage and covered by a type of foam rubber as used indoll manufacture to simulate the muscle and subcutaneous'tissue andfinally a plastic covering to simulate the skin. If desired, two or moreanatomical models may be used in sizes representing adult and infantlarynxs.

Preferably also, a drawing 8 of a sagittal section through the humanneck is mounted adjacent model 6 and pinpointing the cricothyroid notchand showing the positioning of a hollow bore needle therethrough andinto the interior airway of the throat. Also associated with the modeland drawing are step by stepprinted instructions 9 to hyperextend theneck of the patient; palpate the cricothyroid notch on the model and onthe patient; sterilize the skin of the patient; and pierce the tracheawith the needle being careful to regulate the depth'of penetration. Thusthe user of the device is furnished immediate and complete visual andtactile instructions for making a safe and sure cricothyroidotomy underemergency life-saving conditions. Personnel are desirably encouraged torefresh their knowledge of the critical anatomical landmarks byperiodically palpating the model.

The type of needle used may be left to the discretion of the supervisingphysician. In its simplest form, as here illustrated, it may be a largebore straight needle of suitable length to limit the extent ofinsertion, and preferably with an obturator. With reference to FIG. 4, Iprefer to use a needle 10 comprising a large bore plastic tube 16constructed of a thermal plastic and of a wall thickness resistingcollapse; and an internally mounted metal obturator l7'having asharpened leading edge 18 normally extending beyond the end 19 of theneedle, and a stop or back piece 21 which may be used to force the entryof the needle through the cricothyroid membrane and subsequently effectthe withdrawal of the obturator from the hollow needle which remains inplace to provide the needed supplementary airway. A plastic cannula ispreferred over metal to minimize the risk of injury to the trachealmucosa.

The needle is here mounted in a sterilized container 11 having ademountable closure means 12 such as a threaded cap, permitting removalof the needle at time of emergency use. Preferably all of the parts:model 6, drawing 8, instructions 9, and container 11, are assembled inoperative association on a mounting board 13 which may be convenientlyhung in hospital emergency rooms, doctors offices, and other areas wheremedically trained personnel may be expected to encounter emergency upperairway obstructions in patients. Container 11 is demountably secured onboard 13, as by clip 14 for easy removal, cleaning and sterilization.

Where a relatively large bore cannula is used, there is desirablyincluded in container 11, a pointed scalpel which maybe used toinitially puncture the membrane to open the way for insertion of theneedle.

It will now be clear that the device of the present invention isdesigned not only as a training device but more importantly to provideimmediate and on the spot instruction in the reality of alife-threatening situation to guide medical or paramedical personnel inthe sure, precise, safe and effective performance of acricothyroidotomy.

Iclaim:

1. An apparatus to aid in performing an emergency cricothyroidotomy on apatient having an upper airway obstruction comprising:

a three-dimensional anatomical model of a human throat formed to definethereon a visible and palpable contour of the cricothyroid notch forobservation and tactile contact thereof by a user of said apparatus toaid the user in the location of the corresponding notch on the throat ofa patient;

a hollow bore needle; and

means mounting saidmodel and needle proximate each other with saidneedle demountably secured thereto to permit removal and use to performa circothyroidotomy, said means positionable to a location proximate apatient to be treated.

2. The apparatus in accordance with claim 1 and wherein further adrawing carried by said means, said drawing displaying the sagittalsection through the human neck and a hollow bore needle positionedthrough the cricothyroid notch and into the interior airway of thethroat.

3. The apparatus in accordance with claim 2 and printed instructionsaffixed to said means in association with said model, drawing andneedle.

4. A method for enabling paramedical personnel to perform an emergencycricothyroidotomy on a patient

1. An apparatus to aid in performing an emergency cricothyroidotomy on apatient having an upper airway obstruction comprising: athree-dimensional anatomical model of a human throat formed to definethereon a visible and palpable contour of the cricothyroid notch forobservation and tactile contact thereof by a user of said apparatus toaid the user in the location of the corresponding notch on the throat ofa patient; a hollow bore needle; and means mounting said model andneedle proximate each other with said needle demountably secured theretoto permit removal and use to perform a circothyroidotomy, said meanspositionable to a location proximate a patient to be treated.
 2. Theapparatus in accordance with claim 1 and wherein further a drawingcarried by said means, said drawing displaying the sagittal sectionthrough the human neck and a hollow bore needle positioned through thecricothyroid notch and into the interior airway of the throat.
 3. Theapparatus in accordance with claim 2 and printed instructions affixed tosaid means in association with said model, drawing and needle.
 4. Amethod for enabling paramedical personnel to perform an emergencycricothyroidotomy on a patient having an upper airway obstructioncomprising: examining an anatomical model of the human throat formedwith a cricothyroid notch for visual and tactile determination of thelocation of said notch; locating the corresponding cricothyroid notch onthe patient; referring to a drawing of a sagittal section through thehuman neck and a hollow bore needle positioned through the cricothyroidnotch; and inserting a hollow bore needle through the cricothyroid notchof the patient and into the interior airway of the patient''s throat inaccordance with said drawing.